You can never go home again, but the truth is you can never leave home, so it's all right. -- Maya Angelou

Friday, September 26, 2008

Improbability

Warning: this post contains gross health details that you may want to avoid!

You know how, in some books, you’ll come upon a plot twist so unbelievable, so absurd, so manufactured to fit an implausible story line, that you throw the book at the wall in disgust? You know the ones: the long-lost rich relative conveniently dies, leaving a poor earnest orphan rich beyond her wildest dreams, or alternatively, leaving a cool house in Tuscany/France/fill-in-place-here. Or, maybe it’s about a man who falls in love with a woman simply by seeing her photograph (or in the course of a single meeting) and spends ginormous amounts of time and money trying to find her – and, of course, he DOES and she immediately falls in love with him too. There are any number of variations, including ones that don’t involve at least one super-rich person, but the common thread is that they always lead to the implausible situation. I had one of those plot twists in real life this week, which, in a book, I would have instantly scoffed at. Seriously – I’d have considered a book with this plot twist a total wall-banger.

What happened? Well, to explain, I have to go back a bit – to when we first moved to Washington. We’d only been there a couple of days; literally, the movers were still at my house unpacking. I got a terrible stomach pain, and I had to go to the Emergency Room. It turned out that I had a partial intestinal obstruction, a condition that can be life threatening, and I had to spend my first week on Whidbey Island in the hospital. There are only two treatments for an intestinal blockage: conservative treatment, which involves having a nasogastric (NG) tube put through your nose into your stomach for several days, while at the same time, not having any food or water, so your digestive system can rest – and surgery. Conservative treatment is hideous – I wouldn’t wish an NG tube on my worst enemy – but it’s always the preferred treatment because with surgery, there’s an uncomfortably large risk that the blockage will re-occur. If conservative treatment fails, or if the blockage is complete, rather than partial, then surgery is required. Without surgery, your intestines will die, and then you, too, will die. It’s a complex situation, but the treatment decision is pretty simple.

I was lucky that time because the conservative treatment worked, mostly. I continued to have a blockage, but it resolved enough that I was able to manage it by being super careful about what I ate – no fiber, including one of my favorites, berries – and no food at all when I felt it getting worse. Still, I considered myself lucky because the surgery was supposed to be so risky and painful that it seemed like a much worse alternative. Because it was so horrible to go through, I spent a lot of time working out the events that led up to getting sick so I could avoid them in the future. When it happened, I’d just completed the long-distance drive from Texas to Washington, and I was in the process of unpacking my stuff in the new house. I was also completely overloaded with stress and “to do” list items and I hadn’t been eating right at all.

Naturally, I thought of all those things when I was planning my recent move to Texas – so many of the same elements were due to be repeated, in an almost identical fashion. But I was really careful, in spite of my moaning about Prissy, to space out my driving so that I wouldn’t be spending so much time each day in the car, and DH came to Washington to help with the movers, so I wouldn’t have to deal with that on my own.

And it seemed as if my careful plans had worked, in spite of all the problems we had getting back to Texas. By Saturday, I was feeling OK and DH and I went out to look at cars (his is on its last legs), with plans to visit the mall afterwards to see if I could pick up some hot-weather clothing at an end-of-season sale. We were at the mall when I got an awful pain in my stomach. At first, I thought it was just the Mexican food I’d eaten the night before and I tried to ignore it. But it got worse and I told DH I thought we’d better go. He must have known something really bad was happening because he knows I have to be nearly dying to cut a shopping trip short!

DH asked if I wanted to go to the hospital, and at first, I said no, so we went back to the apartment, where I lay down and tried to wait out the pain – I still thought (hoped) it might go away – I didn’t immediately think it had anything to do with my obstruction. But it got worse and worse. In fact, it got so bad, I thought I really might be dying, and I finally, reluctantly, agreed with DH that I needed to go to the hospital after all.

He took me to a hospital that he knew of because it was on one of his running-routes, a fortunate choice too, because it turned out to be one of the best in the city. The waiting room was crowded and my heart sank because I wasn’t sure how long I was going to last sitting upright in a hard chair, but there was a nurse doing triage and she sent me back to a room (with a bed) right away.

I saw the doctor and gave him my history, and he sent me for a CT scan, the results of which produced my bizarre plot twist. My pain was caused by an intestinal blockage, and this time it was complete. In other words, conservative treatment was not an option. I needed surgery right away because my small intestine was ischemic, which meant it was starved of blood supply and was already beginning to die. It was just too bizarre to think that the first blockage was caused by the events surrounding my move from Texas to Washington, and this new one was caused by moving back! As I said, if I’d read it in a book, I’d never have believed it; I’d have pitched the book at the wall.

I had surgery last Sunday (today is Friday), and it was even worse than I’d imagined it could be. The surgeon, who was terrific, started out trying to just open up the blockage with a small incision and a laparoscope, but when he got inside, he found sections of dead bowel, so he had to convert the surgery to a complete open (big incision) one and he had to do a complete resection of my small intestine, which involved cutting out the dead bits and sewing the remaining, healthy bits back together.

I went into the surgery hoping to come out with just a small laparoscopy scar and no blockage, and I came out with no blockage (yay!), but with a huge 5-inch long vertical scar, plus another small vertical scar and accompanying drain. In addition, I given a central line because my veins were insufficient for the IVs I needed. For the uninitiated – like me, till I had one, a central line is a kind of IV port with caps on it where different needles can be inserted, while leaving others free for drawing blood and giving injections. The central line was startling because it’s much larger and more permanent looking than a regular IV, and it was placed in the most uncomfortable position on my neck. And it was “installed” there, not just stuck on with tape. And, as if all that wasn’t enough, even though the conservative treatment hadn’t been an option, I was stuck with an NG tube too. ~Shudder!

I’ll tell you what – it’s a pretty big attitude adjustment to go from looking at David Meister dresses at Neiman Marcus on Saturday, to facing the surgery I just described on Sunday.

There was one bright side to all this misery – I got an immediate payback for moving to Texas. DH called Auntie on Sunday to tell her about my surgery and she arrived in my room on Monday. She was a God-send. She spent every day this week keeping me company; she took care of the dogs while DH was at work; she brought me magazines and face cream; she helped bring home some of the gorgeous flowers I received so I could enjoy them at home; she even brought ME home from the hospital because DH was in a meeting he couldn’t get out of when I was finally released, and, now that I’m home, she’s making me my grandmother’s favorite baked custard, which is fabulous because there are very few things that I’m allowed to have, but that’s one of them. She’d have come to Washington if I’d asked her to, but because we weren’t so far away, she was able to get here in time to really make a difference. I expect she’ll read this at some point, so here’s to you, Nancy Barber. You are the best!

Auntie’s going back to Little Rock tomorrow, and I have a huge long recovery ahead, but I’m not as down as I might have been otherwise because I’m so grateful for all the support I received from my friends and family. In addition to Auntie coming to stay with me, my Uncle Mack and Aunt Shirley and my mother sent me amazing flowers. And, most importantly, DH went so far above and beyond to take care of me that I still cannot believe it. Even though his back has to be KILLING him by now, DH spent every night in a chair in my room so I didn’t have to be alone. Every night he stayed – all night. And he brought me every single thing I asked for, e.g. he raced out to get me a hair dryer on a moment’s notice because I got to have an unexpected shower and I was going to be cold if I couldn’t dry my hair. Gillian called me twice and talked for hours, although it must have been seriously expensive; and my friends on Penman Review cheered me up by playing along with the pathetic missives I sent from my mobile phone.

I, too, had a central line put in after my ruptured appendix last year. But it was put in while I was AWAKE!!!!!! I have never been more frightened of a procedure in my life. My doctor told me later that they are normally put in during surgery. Duh! Wonder why? Anyway, glad you are better. These intestinal problems are not fun are they?

I am so glad you are now off the cruise ship Tam. I've been away from the PC a lot of this weekend, and I was wondering how you were doing. Just checked the blog tonight before logging off. My goodness what an ordeal!I so hope that you're luck has now changed!Hugs